WOODWARD DETROIT CVS, L.L.C. (NPI# 1366541666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366541666 |
| Entity Type | Organization |
| Organization Name | WOODWARD DETROIT CVS, L.L.C. |
| Other Organization Name | CVS PHARMACY #08290 |
| Practice Address |
3601 Clyde Park Ave Sw Wyoming MI 49509-4023 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 6162576641 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2012-02-29 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR) |
| Authorized Official Telephone | 4017651500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | 5301-007210 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2361474 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #08290 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861796112 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3590 Plainfield Ave Ne, Grand Rapids, MI 49525-2719 | 2010-12-30 |
| 1790002921 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 5449 Jackson Rd, Ann Arbor, MI 48103 | 2010-04-28 |
| 1033374319 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 7488 Village Center Dr., Whitmore Lake, MI 48189 | 2008-07-25 |
| 1922273424 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 57090 Ten Mile Rd, South Lyon, MI 48178-9718 | 2008-04-25 |
| 1922271162 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 15521 West Seven Mile Road, Detroit, MI 48235 | 2008-04-09 |
| 1326216797 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 44300 Five Mile Rd., Northville Township, MI 48167 | 2008-02-19 |
| 1538352976 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 51000 Romeo Plank Rd, Macomb, MI 48042-4128 | 2007-08-20 |
| 1144429952 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5756 Clarkston Rd, Clarkston, MI 48348-4706 | 2007-07-12 |
| 1811195993 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 50980 North Ave, Macomb, MI 48042-4626 | 2007-07-10 |
| 1356481352 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5408 Whittaker Road, Ypsilanti Township, MI 48197 | 2007-02-07 |
| Street Address |
3601 CLYDE PARK AVE SW |
| City | WYOMING |
| State | MI |
| Zip Code | 49509-4023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960437 | Ryan Brophy | Pharmacist | 3601 Clyde Park Ave Sw, Wyoming, MI 49509-4023 | 2020-07-27 |
| 1639702319 | Travis Galloway | Pharmacist | 3601 Clyde Park Ave Sw, Wyoming, MI 49509-4023 | 2020-02-20 |
| 1154952349 | Bridget Burns | Pharmacist | 3601 Clyde Park Ave Sw, Wyoming, MI 49509-4023 | 2020-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023620713 | Lindsay Kayann Ottowitz | Behavior Technician | 1428 44th St. Sw, Wyoming, MI 49509 | 2020-08-23 |
| 1750990016 | Lindsay Alexandra Lyszczarz | Behavior Technician | 5281 Clyde Park Ave Se, Suite 2, Wyoming, MI 49509 | 2020-07-23 |
| 1033690409 | Courtney M Garner | Behavior Technician | 1428 44th Street, Wyoming, MI 49509 | 2018-08-23 |
| 1457857195 | Ashley Mae Autio | Case Manager/Care Coordinator | 795 36th Street, Wyoming, MI 49509 | 2018-04-02 |
| 1689124588 | Jacqeulyn Harmon | Behavioral Analyst | 2819 Peckheath Rd Sw Apt D, Wyoming, MI 49509 | 2016-10-04 |
| 1275988925 | Intsar Abdulahe | Social Worker | 1551 Charles Russell, Wyoming, MI 49509 | 2016-05-02 |
| 1992160071 | Concierge Home Care Services of West Michigan, LLC | Home Infusion | 1360 56th Street Sw, Wyoming, MI 49509 | 2015-12-16 |
| 1417349796 | Yashana Duncan | Case Manager/Care Coordinator | 225 Colrain St. Sw, Suite 2, Wyoming, MI 49509 | 2015-02-24 |
| 1710378377 | Rawm Vascular Access, Pllc | Internal Medicine | 1540 36th Street. Sw, Wyoming, MI 49509 | 2015-02-17 |
| 1366882755 | Kevin Timothy Solt | Dentist | 1535 44th St Sw Ste 200, Wyoming, MI 49509 | 2013-06-28 |
| Find all providers in zip 49509 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700341708 | Richard Garcia | Pharmacy | 1148 28th St Sw, Wyoming, MI 49509-2855 | 2019-02-04 |
| 1437629268 | Family Fare LLC | Pharmacy | 1550 Gezon Pkwy Sw Ste E101, Wyoming, MI 49509-9397 | 2018-12-05 |
| 1689182479 | Family Fare, LLC | Pharmacy | 1550 Gezon Pkwy Sw Ste E-101, Wyoming, MI 49509-9397 | 2018-01-16 |
| 1073617031 | Parkwood Pharmacy LLC | Pharmacy | 1106 Burton St Sw, Wyoming, MI 49509-1435 | 2006-09-12 |
| 1710090295 | Price Chopper Operating Co of Pa Inc | Pharmacy | 1026 Wyoming Ave, Midway Shopping Center, Wyoming, PA 18644-1331 | 2006-08-17 |
| 1093287443 | Family Fare, LLC | Pharmacy | 1550 Gezon Pkwy Sw Ste E-101, Wyoming, MI 49509-9397 | 2018-12-26 |
| 1649531732 | Fairview Lakes Pharmacy - Wyoming 340b | Pharmacy | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2012-06-05 |
| 1700921384 | William R Seitzinger | Pharmacy | 299 Wyoming Ave, Wyoming, PA 18644-1620 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961763 | Dustyn Daniel Thoney | Pharmacy | 530 Harding Ave, Iron River, MI 49935-2265 | 2020-10-27 |
| 1497355697 | Katherine Jane Cybulski | Pharmacy | 1310 Waukazoo St, Hastings, MI 49058-9559 | 2020-10-27 |
| 1043836042 | Hanan Pharmacy LLC | Pharmacy | 4600 E 14 Mile Road, Suite 2, Warren, MI 48092-1057 | 2020-06-25 |
| 1770104192 | Hazelwood Pharmacy LLC | Pharmacy | 624 E 9 Mile Rd Ste C, Hazel Park, MI 48030-1842 | 2020-04-27 |
| 1457980609 | Berkley Pharmacy LLC | Pharmacy | 28577 Schoenherr Road, Warren, MI 48088 | 2020-04-08 |
| 1669012316 | Warriors Pharmacy, Inc. | Pharmacy | 5265 Anthony Wayne Dr, Detroit, MI 48202-3947 | 2020-01-10 |
| 1457996662 | Sunrise Pharmacy, LLC | Pharmacy | 989 University Dr Ste 104, Pontiac, MI 48342-1885 | 2019-11-12 |
| 1447894019 | Nova Pharmacy | Pharmacy | 15140 Levan Rd, Suite 40, Livonia, MI 48154 | 2019-11-06 |
| 1912541673 | Wayne Pharma | Pharmacy | 974 Ford Ave, Wyandotte, MI 48192 | 2019-11-05 |
| 1639720667 | Grand Haven Pharmacy LLC | Pharmacy | 930 John R Rd Ste Pharmacy, Troy, MI 48083-4316 | 2019-09-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.